Nurse Kristi Owen prepares to wrap a baby girl in a blanket in the nursery at Saint Thomas-Rutherford Hospital in Murfreesboro. / John A. Gillis / Gannett Tennessee

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One storyline among the many surrounding health care reform is how nursing as we know it could transform. Listen to any hospital company’s earnings call, or attend the keynote of a health care conference, and you’ll probably hear how the industry is shifting more care toward prevention, out into communities — and into the hands of nurses.

The problem, according to Carol Etherington, nursing professor and associate director of the Vanderbilt Institute for Global Health, is that too few nurses are in positions to lead the sweeping industry discussions that will directly affect their jobs.

“There’s kind of a 30,000-foot decision-making process about care that doesn’t engage those that are actively putting it in place,” she said. “Consequently, that involves lost lives and lost dollars.”

Etherington is taking a step toward addressing that problem through her work at the Nursing Leadership in Global Health Symposium, which is happening this week.

“We decided that (the conference) really was going to be about nursing leadership and global health and how, in coming years, the voice of nurses had to be elevated,” she said.

The event will take place Thursday and Friday at the Renaissance Nashville Hotel downtown. Speakers include former U.S. Sen. Bill Frist, Partners in Health Chief Nursing Officer Sheila Davis and Jordanian Princess Muna al-Hussein, who heads the Jordanian Nursing Council.

The future of nursing is a tremendous workforce issue in the United States, said Peter Buerhaus, a professor of nursing at Vanderbilt. “I think the employment opportunities for nurses will just expand beyond imagination as this point.”

“With more than 3 million members, the nursing profession is the largest segment of the nation’s health care workforce,” according to a 2010 report on the future of nursing by the Institute of Medicine. “Working on the front lines of patient care, nurses can play a vital role in helping realize the objectives set forth in the 2010 Affordable Care Act.”

But there are obstacles between now and a new world of care that aligns payment with quality and gives nurses a voice.

One issue that needs to be addressed, Buerhaus said, is nursing education.

“The education system is still kind of churning out nurses for what used to be and not where we’re going,” he said. For example, nurses are trained for acute care positions in hospitals, even though the industry is moving more care out of hospitals. Part of that, Buerhaus said, is because some of the tests that nurses must pass to get their licenses require knowledge of a kind of health care system that is quickly becoming outdated.

Another issue, Buerhaus said, is that nurses are used to doing a tremendous amount of grunt work. That may no longer be necessary as providers add less-expensive staff to complete entry-level health care tasks.

“They’re used to doing it all, and the system kind of rewarded them for that,” he said. “Now they’ve got to pull back and say, ‘You know, that’s not a good use of my time.’ ”

Nurses must advocate for themselves, he said. Etherington agrees. “I think that nurses do have to be accountable at times for not being in those chairs of influence.”

Hopefully, she said, events such as this week’s conference will help.

“One of our goals is to build new and strengthen existing coalitions between and among nurses and other providers who all share the concept of elevating the voice of the people who provide direct care, and elevating the voice of the patients themselves,” she said.

Nurses do, after all, tend to be good patient advocates, Buerhaus said. Why not use their expertise to guide the road toward a reformed health care system? If health care reform works, “We should have people doing the things that they do best at a lower cost,” Buerhaus said.

“I just hope we get there. I’m more optimistic than I’ve ever been.”

Reach Shelley DuBois at 615-259-8241 and on Twitter at @shelleydubois.